Association of infections and venous thromboembolism in hospitalized children with nephrotic syndrome

Shannon L. Carpenter, Jennifer Goldman, Ashley K. Sherman, David T. Selewski, Mahmoud Kallash, Cheryl L. Tran, Meredith Seamon, Chryso Katsoufis, Isa Ashoor, Joel Hernandez, Katarina Supe-Markovina, Cynthia D’alessandri-Silva, Nilka DeJesus-Gonzalez, Tetyana L. Vasylyeva, Cassandra Formeck, Christopher Woll, Rasheed Gbadegesin, Pavel Geier, Prasad Devarajan, William E. SmoyerBryce A. Kerlin, Michelle N. Rheault

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Background: Nephrotic syndrome (NS) results in hypercoagulability and increased risk of infection. Furthermore, infection increases the risk of venous thromboembolism (VTE). Our objective was to determine the prevalence of infection, VTE, and the associated outcomes among a cohort of hospitalized children with NS. Methods: All children with NS admitted to 17 pediatric hospitals across North America from 2010 to 2012 were included. Prevalence of infection and VTE was determined. Wilcoxon rank-sum and logistic regression were performed. Results: Seven-hundred thirty hospitalizations occurred among 370 children with NS. One-hundred forty-eight children (40%) had ≥ 1 infection (211 episodes) and 11 (3%) had VTE. Those with VTE had infection more frequently (p = 0.046) and were younger at NS diagnosis (3.0 vs. 4.0 years; p = 0.008). The most common infectious pathogen identified was Streptococcus pneumoniae. The median hospital length of stay for those with infection [10 vs 5 days (p < 0.0001)] or VTE [22 vs 6 days (p < 0.0001)] was longer than those without either complication. Of those with infection, 13% had an intensive care unit (ICU) stay compared with 3.3% of those without infection. Median ICU stay was 4 days in those with VTE compared to 0 days in those without (p < 0.001). By logistic regression, only the number of ICU days was associated with VTE (OR 1.074, 95% CI 1.013–1.138). Conclusions: Hospitalized children with NS have high rates of infection. Presence of VTE was associated with infection. Both were associated with longer hospitalizations and ICU stays.

Original languageEnglish (US)
Pages (from-to)261-267
Number of pages7
JournalPediatric Nephrology
Volume34
Issue number2
DOIs
StatePublished - Feb 1 2019

Keywords

  • Focal segmental glomerulosclerosis
  • Infection
  • Infection
  • Minimal change disease
  • Nephrotic syndrome
  • Venous thromboembolism

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Nephrology

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    Carpenter, S. L., Goldman, J., Sherman, A. K., Selewski, D. T., Kallash, M., Tran, C. L., Seamon, M., Katsoufis, C., Ashoor, I., Hernandez, J., Supe-Markovina, K., D’alessandri-Silva, C., DeJesus-Gonzalez, N., Vasylyeva, T. L., Formeck, C., Woll, C., Gbadegesin, R., Geier, P., Devarajan, P., ... Rheault, M. N. (2019). Association of infections and venous thromboembolism in hospitalized children with nephrotic syndrome. Pediatric Nephrology, 34(2), 261-267. https://doi.org/10.1007/s00467-018-4072-6